| NPI | 1083866370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARATH B DOMMARAJU President 1919-858-0600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: NC 2007-00317) |
| Enumeration Date | 2008-10-17 |
| Last Update Date | 2008-10-17 |